Is D48.7 a billable ICD-10-CM code?

Yes. D48.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D48.7 sit in the tabular list?

Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).

What cannot be coded together with D48.7?

D48.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D48.7

D48.7 — Neoplasm of uncertain behavior of other specified sites

Billable / specific codeICD-10-CM

D48.7 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of other specified sites. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

neoplasm of uncertain behavior of connective tissue (D48.1-)
neoplasm of uncertain behavior of skin of eyelid (D48.5)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Neoplasm of uncertain behavior of eye
Neoplasm of uncertain behavior of heart
Neoplasm of uncertain behavior of peripheral nerves of orbit

Other codes that can never be billed with D48.7

These codes carry an Excludes1 note pointing at D48.7. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D48.7 alone.

D38Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs
D38.5Neoplasm of uncertain behavior of other respiratory organs
D48.2Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system

Risk adjustment

D48.7 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D48.7 is named in 28 Medicare coverage policies — 28 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A55717Billing and Coding: Lab: Flow Cytometry

Related codes at this level

Codes that share D48. If D48.7 is not quite right, the correct code is usually one of these.

Questions about D48.7

Is D48.7 a billable ICD-10-CM code?: Yes. D48.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D48.7 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).
What cannot be coded together with D48.7?: D48.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.